Range of Motion After Ankle Self-Stretching Using a Strap

I, Kwon O, Yi C, Cynn H, & Hwang U. J
Athl Train
. Published Online First: December 3, 2015; DOI: 10.4085/1062-6050-51.1.01

Take Home Message: A dynamic self-stretching technique may
improve dorsiflexion even better than traditional self-stretching due to a
strap that aids in gliding the talus posteriorly relative to the distal tibia
to improve arthrokinematics.

ankle dorsiflexion may contribute to many acute and chronic lower extremity
pathologies (e.g., ligament tears, sprains, tendinitis, fasciitis).  Improvements in ankle dorsiflexion may aid in
the reduction and/or prevention of these pathologies. The authors of this
randomized controlled trial developed a novel self-stretching technique with a
strap (SSS) that combines a weight-bearing stretch with a gliding motion at the
talocrural joint.  The goal of their
clinical trial was to compare the effects of a 3-week program using a
traditional static stretch or SSS on change in ankle dorsiflexion among
individuals with limited dorsiflexion. Thirty-two healthy participants who had
limited active dorsiflexion while seated were randomized to the SSS group or
the traditional stretching group.   One
traditional stretching group participant withdrew from the study for a total of
31 participants. The SSS group used a stabilizing strap on the talus aimed to improve
ankle dorsiflexion in a dynamic lunge position with the foot on a 10-degree
incline board. The traditional stretching group held a static stretch on the
10-degree incline board.  All
participants completed the assigned stretch with supervision 5 times per week
for 3 weeks (15 repetitions/session with 20 second holds). Clinicians, who were
unaware of who received each treatment, measured active dorsiflexion, passive dorsiflexion,
and lunge ankle angle before and after the 3-week intervention. While both
groups improved over time, the SSS group had greater ankle dorsiflexion
(passive, active, and lunge angle) after completing the stretching program than
the traditional stretching group when the authors accounted for a participant’s
initial range of motion.

previous SMR post demonstrated
improvements over the course of a 6-week program. However, the authors of this
study discovered that both self-stretching techniques improved ankle dorsiflexion
in just 3 weeks, and that the novel stretching technique had better outcomes in
all 3 dorsiflexion measures than the traditional stretching technique.  The addition of the strap in the SSS
technique allowed for a dynamic posterior joint mobilization, which may have addressed
any arthrokinematic restrictions that limited dorsiflexion.  One limitation of this study was that the
study population consisted of young, healthy participants without a history of
injury.  Therefore, it is unclear if
these findings can be applied to athletes with a history of ankle injury.  Future research could explore this question
and assess if this technique could be used to improve chronic symptoms or prevent
acute injuries.  Regardless, clinically
it is important to assign home exercise programs that consist of frequent
stretching to individuals with limited dorsiflexion. Clinicians may consider
trying the SSS since it out performed a traditional stretching technique and
may pose minimal risk to a patient. 

for Discussion:  Are there any other
self-stretching techniques that you have utilized in individuals with limited
dorsiflexion?  What has your experience
been with trying to improve range of motion in patients with limited

by: Nicole Cattano
by: Jeffrey Driban


Jeon IC, Kwon OY, Yi CH, Cynn HS, & Hwang UJ (2015). Ankle-Dorsiflexion Range of Motion After Ankle Self-Stretching Using a Strap. Journal of Athletic Training PMID: 26633750